Tuesday, 15 Feb 2022  |  Reading time:  12 mins  | Read online

Sexual health services

Each week we focus on a different global topic, highlighting innovative content and insights from LGIU and our members around the world.  

With Valentine’s Day drawing attention to romance this week, this edition of Global Local focuses on local government’s role in sexual health services. As Covid-19 restrictions ease, many people feel more comfortable seeking out new sexual partners or casual relationships again. However, sexual health services are still severely disrupted, potentially putting people at greater risk of contracting sexually transmitted infections (STIs).
 
How has the pandemic affected sexual health services? Many clinics were forced to close due to restrictions and staff being redeployed for Covid-19 responses. Services judged to be essential were prioritised, such as emergency contraception and sexual assault care. Many services were shifted online or by phone where possible. School closures disrupted sexual and relationships education, which was often not part of online learning.
 
What were the impacts of this disruption? Early data indicates this disruption has had significant, lasting impacts on gender equality globally. Contraceptives and family planning advice were harder to access, leading to more unplanned pregnancies and interruptions to long-term campaigns for women’s sexual and reproductive rights. Domestic violence cases rose globally by up to 33% in 2020. STI testing rates dropped, including HIV testing. While telemedicine improved access to services for some, it excluded others, including the most vulnerable, and exacerbated the digital divide.
 
What can local governments do to support service recovery? Councils with commissioning roles should ensure that restored services meet the needs of all community members, including LGBTQIA+ and culturally and linguistically diverse people, by identifying service gaps, looking for partnership opportunities, and balancing accessible digital services with in-person delivery. All councils can communicate clearly about local sexual health services and resources, using pandemic public health communication lessons.
 
Who inspired us this week? We loved the innovative approaches to sexual health service delivery in the UK and Canada highlighted in our new briefing and women's health education for new Afghan migrants to Karlstad, Sweden.

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This week's featured content

Sexual health services: how local government can effectively deliver to communities

By Louise Honeybul, LGIU Associate

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Currently, sexual health services in many countries are underfunded and councils are seeking new ways to diversify care and improve access to services. Councils are uniquely positioned to respond directly to the needs of their constituents and strive to make services available that support historically hard-to-reach populations such as people of colour, immigrants and refugees, and the LGBTQIA+ community.

Supporting and funding sexual health services is important; investing in effective, preventative services, such as family planning and easy-to-access STI testing, reduces unwanted pregnancies and severe illness as a result of infections. As digital services expand, investing in clear online signposting, user-friendly platforms, and provision of high-quality, easy-to-understand information is an essential next step.

Integrated services that combine family planning, genitourinary medicine and other services are crucial to mitigating funding challenges. Integrated models create more opportunities for preventative intervention, swifter diagnoses and treatment pathways, and holistic sexual health and wellbeing care. Partnering with third sector organisations and start-up companies can offer innovative ways to reach populations and strengthen sexual health services offered by local authorities that may be experiencing funding cuts.

How are councils best able to collaborate, harness innovation, and deliver effective sexual health care to their communities?

LGIU Global Local Highlights

 

Still unequal: dealing with health inequalities through the pandemic and beyond

This long read examines the issues of health inequalities as we understood them before the pandemic, the impact of Covid-19 and what steps we can take to address inequity now. 
Read our research paper here.

Local government’s role in the epidemic of violence against women

The United Nations has designated 25 November as the International Day for the Elimination of Violence Against Women. The important question is how can this translate into action at a global level? As local authorities know all too well, it all begins with action at a local level. 
Read our content here.

DfE relationships, sex education and health education – implementation

This briefing covers the relationships, sex and health education curriculum for schools in England and the requirement on all English schools (including independent) to teach a common relationships and sex education curriculum from September 2020. 
Read this briefing here.

Missed last week's Global Local? Click here to read how issues of central vs local control can become life and death matters when it comes to health inequalities.

Innovation & Inspiration

Curated case studies from around the globe

Sweden: Women’s health education supports new Afghan migrants

An educator who teaches recently migrated women from Afghanistan and Iran about Swedish sexual and reproductive rights was recognised with a national sex education award. Noorihe Halimi teaches recent migrants and refugees in Dari and Farsi about menstruation, contraception, abortion, pregnancy, and how to navigate the Swedish healthcare system. Halimi moved to Sweden 25 years ago to escape war in Afghanistan and works for the association ‘An opener Kronoparken’: a collaboration between Karlstad Municipality and Värmland student unions and associations.
WHO Regional Office for Europe - YouTube / SVT News / Amanda Moln
Together in Karlstad

Global: Cities worldwide commit to accelerated HIV responses and collaboration

More than 350 municipalities have joined the Fast-Track Cities Initiative: a global partnership seeking to end the HIV, tuberculosis, and viral hepatitis epidemics in cities by 2030. Participating cities develop locally-based strategies to reach 90-90-90 targets, with progress tracked on live online dashboards. Effective local initiatives include Bangkok, Thailand, making prevention medication PrEP available in 16 municipal public health centres and running a citywide PrEP campaign featuring transgender women and Kigali, Rwanda, distributing free condoms through kiosks in hotspot areas.
UNAIDS / Fast-Track Cities Global Web Portal

China: Community engaged in contests to design STD testing campaigns

A collaborative USA-China research project invited people in at-risk groups to develop images and videos for campaigns around sexual health, condom use and testing for HIV and hepatitis B and C. The Social Entrepreneurship for Sexual Health project allowed people in vulnerable groups—including young people, LGBTQIA+ people and men who have sex with men—to submit images that resonated with them, which were used for community-led, bottom-up campaigns. The contests themselves also raised awareness and testing rates of sexually transmitted diseases, which were rising in China and widely considered taboo.
Social Innovation in Health Initiative / Infectious Diseases of Poverty / Megan L. Srinivas et al.

Australia: User-friendly ‘Planet Puberty’ site supports kids with intellectual disability

A space-themed digital resource suite helps children with intellectual disability and/or autism spectrum disorder (ASD) to understand and navigate bodily changes during puberty. The ‘Planet Puberty’ website was co-designed throughout with Australian adults with intellectual disability and/or ASD. Resources include strategies, activities, and questions for parents and carers to use to support their children, themed around areas such as relationships, body, emotions, and identity. The free, colourful, and accessible website was developed by Family Planning NSW and funded by the Australian Government's Department of Social Services.
Planet Puberty

Policy & Resources

Research, analysis and examples of policy in practice from leading institutes and places like yours

Guidance: Restoring Sexual & Reproductive Health Services during Covid-19 (Faculty of Sexual & Reproductive Healthcare, UK)

This concise document outlines principles for restoring sexual and reproductive health (SRH) services disrupted by the pandemic. It highlights which services to prioritise, which at-risk groups need particular support, and which positive changes enforced by the pandemic should stay after recovery.

Tool: Sexual and reproductive health: return on investment (UK Government)

This return on investment tool estimates the wider cost savings and benefits from commissioning different types of sexual and reproductive health interventions to support young people (aged 15 to 24), both locally and nationally.

Report: The effects of Covid-19 on Sexual and Reproductive Health: A Case Study of Six Countries (iMMAP, USA)

This report uses data to assess the impact of the Covid-19 pandemic on SRH in Bangladesh, Burkina Faso, Colombia, Democratic Republic of Congo, Nigeria, and Syria. It identifies access barriers, changes to health seeking behaviour, and health system resilience issues, and compares impacts with data from previous health crises.

Case studies: Covid-19 IPPF Innovation and best practice (International Planned Parenthood Federation)

These case studies highlight innovative ways that governments and organisations adapted SRH services during the pandemic, including digitalising services for young people, responding to gendered violence, and integrating telemedicine abortion care. Learning briefs from 16 countries including Ireland, Estonia, Serbia and Indonesia include recommendations for governments and SRH services.

Interested in more LGIU Global content?

Revisit: Can lifting up local be centrally led? Global levelling up lessons

Last week, Global Local explored challenges linked to central and local government relations globally. This related blog highlights international regional inequality case studies and lessons from a recent CIPFA report. 
Read the blog here.

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Blog: Libraries: dedication to public service

Karen Fraser, Executive Manager at Shetland’s Library Services, Scotland, writes about how libraries are needed more than ever in this time of social crisis and staff are rising to the challenge. Read the blog here.

Thanks for reading!

Next week, we’ll look at housing affordability and explore the role that local government can play in helping to address this crisis.

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